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HomeMy WebLinkAbout02-0423 Estate of ,~,.qu' d ,to/? also known as PETITION FOR PROBATE and GRANT OF LETTERS S A~(J k No. To: 21-02-423 Register oflillS for the . County of I/m~pllJ..u d in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the ex~.p/x in the last will of the above decedent, dated dJ e-; "'--.; , and codicil(s) dated !2fceased. Social Security No. eQ. t)Lj -6;. ~ ~ M 9' named ,.~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C (/ mv6iY P //J.A/' <i h last family or principal residence at .15tJ Clt: / L/ P e County, Pennsylv;wia, with ~ci .L~itJL# ~A - d.f n~ ,t</:lb.tJ~ ~ (list street, number and muncipality) Decendent, then /7 rfl/ L ./..:j-, l-9c/t1 d ~, at Except as follows, d edent did n t marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: i.~ Vi-I v~~ ~ci ~ya ,!, ,-7 0 ~ .tl,-!J $ t,~"trO $ $ $ 9,1 , rr--O r p--r::J . / WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters -t"eri /J@ e./l/"7,q JP V (testamentary; administration c.I.a.; administration d. b.n.c.l.a.) theron. '" ~ V> ~ ., u C ., -o~ 'Vi~ ., .... ~., C -00 C";:: ro'';:: 3~ ., '- :; 0 ';;j C OJ) Vi Jj~rA~j~~ CZ:3~; r 4U1t~/9 {~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF ClJ!1BERLAND j The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. ( 2AAX~ /7I..J~ 7 affirmed and 26th V:l ~. ::s I::l ~ ~ ~ 1?-60 -.3 No. 21-02-423 Estate of SANDRA SHERK , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 26. 2002 :l9._, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated OCTOBER 3. 200 1 described therein be admitted to probate and filed of record as the last will of SANDRA SHERK TESTAMENTARY JUDITH A WISMAN and Letters are hereby granted to \ ~~ /??hi/(? ~hf~~J~.J~ . egister of Wills FEES Probate, Letters, Etc. ......... Short Certificates( ).......... If;t&welh~ion ................ JCP $ 200.00 $ 1') . 00 $ 9..00 $ 5.00 TOTAL _ $ 229.00 '" .~~~~.. .?~}. .~q9~.............. ATTORNEY (Sup. Ct. LD. No.) ADDRESS Filed PHONE r- 0-'" " ,'~ ;.._", r', r-:::J ~'-.J P r .... r-;~ oJ "'-_ 21-02-423 LAST WILL AND TESTAMENT OF SANDRA SHERK I, Sandra Sherk of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind, hereby make, publish and declare this to be my Last Will and Testament hereby revoking all former Wills and Codicils made by me. ITEM I: I direct that all my legal debts and funeral expenses shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I direct and bequeath all of my estate of every nature and wherever situate to my sister, Judith A. Wisman, providing she shall survive me by thirty days. ITEM III: In the event my sister predeceases me or dies on or before the thirtieth day following my death, I devise and bequeath all of my estate of every nature and wherever situate, in equal shares, to: Todd B. Wisman, Jeffrey M. Wisman, and Jamie L. Daugherty, who survive me. If any of the above do not survive me, I give his or her share to such person's issue, per stirpes, who survive me. ITEM IV: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM V: I appoint my sister, Judith A. Wisman, Executrix of this my Last Will. Should she fail to survive me or is otherwise unwilling or unable to serve then I appoint Todd B. Wisman, Jeffrey M. Wisman and Jamie L. Daugherty, as Co-Executors, of this my Last Will. ITEM VI: I direct that my Executrix or her successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction, and should, notwithstanding this direction, a bond be required, I direct that a surety bond not be required. IN WITNESS WHEREOF, I have hereunto set my hand this 3 r d. day of ,0 c-tobe.r , 200 1. if~cf~ SANDRA SHERK - 2- " The preceding instrument, consisting of this and two other typewritten pages identified by the signature of the Testatrix, SANDRA SHERK, was on the day and date thereof signed, published and declared by SANDRA SHERK, the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. ~lu~ Yf~-L~~ Name Q30 Eo >>k ~ St. Address t" ~ 13. t:J~ . J/~LU f /)] J7q3A Ron tV. ~t'~Md Sf: Address ~j4ltf,fl f) h/2tlu ' Name lfor,tJb()/ji!lt /7/0d. 1291 ahniJt,r/()n !jp. Address Jltt::t:rSl5r./,U B !7/1z -9/37 r I" " COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF ~ a...u\J~U-( \ ) -- --' Dh n We, c;j'l..viD R-IP 3. DcJu<;~ Y /z; ~e4k ,~b6e-/d and Jjl:Afvy oj). /5:JjII1l C No/e/) , the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being fIrst duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed this instrument as her Last Will and Testament and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, in that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and to the best of their knowledge, the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. cY'~ J.~ :;;?LwE- 77 dR-^--, f q~f3~ iAJ-,~ 1!6/lffif' SWORN and Subscribed to and before me this 3, d day of De;\co€.r ,2001. f C;tnolo..... 1A1~v Notary Public o NOTARIAL SEAL L1N~A WITMER, Notary Public Harrisburg, Dauphin County PA My Commission Expires 03-20-2004 INRE: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA. SANDRA SHERK No. 2002-00423 Date of Death: April 15, 2002 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) ofthe Orphans' Court Rules was served on or mailed to the following beneficiaries ofthe above- captioned estate on May 14, 2002. Name Address Judith A. Wisman 11 Randi Road, Enola, P A, 17025 Respectfully Submitted, IRA H. WEINSTOCK, P.C. 800 North Second Street Harrisburg, P A 17102 Phone: 717-238-1657 Dated: 05/14/02 By: q~::io~~ ~ lr> C'-J P ~ _}c COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EXI11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WEINSTOCK IRA H PC SUITE 100 800 N SEOCND STREET HARRISBURG, PA 17102 -------- fold ESTATE INFORMATION: SSN: 204-28-2159 FILE NUMBER: 2102-0423 DECEDENT NAME: SHERK SANDRA DATE OF PAYMENT: 01/22/2003 POSTMARK DATE: 01/21/2003 COUNTY: CUMBERLAND DATE OF DEATH: 04/15/2002 NO. CD 002067 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $10,992.36 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JUDITH A WISMAN C/O IRA H WEINSTOCK PC CHECK# 4939 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $10,992.36 DONNA M. OTTO DEPUTY REGISTER OF WILLS , . REV-1500EX+t8-OO) I!! .. :!Il.'::iG') u..'" lUOU ",..0 U..-' ..ID .. z o i= :5 :J l- ii: c( (J W 0:: z o S :J D.. ~ o (J ~ : ~. -,,' :~ 1.,< .J.... .. ".:-;" ..\... , ~"ii!'-' '~.rj~ ,'. -'..~~I REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W C W (J W C DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SHERK DATE OF DEATH (MM-DD-Year) SANDRA DATE OF BIRTH IMM-DD-Vearj J 04115/2002 02119/1937 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) 00 1. Original Retum o 4. LimiledEstate 00 6. Decedent Died Testate (_"",oIWilI o 9. Litigation Proceeds Received o 2. Supp,mlOntal Retum o 4a. Future Interest Compromise (datBoIdeaIh.. 12-12-82) o 7. Decedenl Mailltained a living Trust__...,oITruot) o 10. Spousal Poverty Credn 1""01_ """"'''.31-91 "" 1-1-95) .... z :!l ~ 0- Il) IU or l!i u THIS SECTION MUST BE COMPLETED. ALL NAME FRED H. WEGE JR. FIRM NAME (~App<able) WEGE ASSOCIATES TELEPHONE NUMBER 717 558-8600 PONDENCE AND C TAX INFORMATION SHOULD BE DIRECTED TO: COMPlETE MAILING ADDRESS 8150 DERRY ST., SUITE B (:) 1-'-1D~S_ FIlE NUMBER 21-020423 "'COi:iNTY'"Cl5OE~---tiiiiER-- SOCIAL SECURITY NUMBER 204-28-2159 THIS RETURN IIlJST BE FILED IN DUPlICATE IlITH TNf REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. RemainderRetum (daI8cfdealtl priortl 12-13-82) o 5. Federal Estate Tax Retum Required .Q.. 8. Total Number of Safe Deposn Boxes o 11.ElecliontotaxunderSec.9113(A)_hSohOI 1. Real Estate (Schedule A) 2. SlOdls and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes ReceNable (Schedule D) 5. Cash, Bank Deposils & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Seoarate Billing Requested 7. Inter-VIVOS TransfelS & MisoeUaneous Non-Probate Properly (7) (Schedule G or L) HARRISBURG 87,191.35 i .0.00 0.00 0.00 6,003.00 21,406.12) . o.ool X _(15) X _(16) 91,603.01 X .12 (17) 10,992.36 X .15 (18) (19) 10,992.36 (1) (2) (3) (4) (5) 8. Total Gross Assets (total Lines H) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debls of Deoedent. Mortgage L~bilnles, & Liens (Schedule i) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Vllue of Estate (Line B minus Line 11) 13. Charitable and Govemmental BequeslslSec 9113 Trusts for which an eleclion to tax has not been made (Schedule J) 14. Net Vllue Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amounl of Line 14 taxable lithe spousal tax rale, ortransfelS under Sec. 9116 (1)(1.2) 16. AmounlofLine 14 taxable at lineal rate 17. Amounlof Line 14 taxable alsibling rate 18. Amounl of Line 14 taxable al col~teral rate 19. Till Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALl QUESllONS ON REVERSe SIDE AND RECHECK MATH < < PA 17111-5212 I (8) 114,600.47 22,997.46 0.00 (11) (12) (13) 22,997.46 91,603.01 (14) 91,603.01 Decedent's ComDlete Address: STREET ADDRESS 60 OLIVER ROAD CITY ENOLA I STATE PA I ZIP 17025.2124 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2, CreditslPayments A. Spousal Poverty Credit 8, Pnor Payments C, Discount (1) 10,992.36 TotaICredns(A+8+C) (2) 3. Interest/Penalty if applicable 0, Interest E, Penalty TotallnteresUPenalty (0 + E) (3) 4, If Une 2 is greater than Line 1 + Une 3, enterthe difference, This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5, If Line 1 + Line 3 is greater than Line 2, enter the difference, This Is the TAX DUE. (5) A, Enter the interest on the tax due, (5A) 8, Enter the total of Line 5 + 5A, This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 10,992.36 10,992.36 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X. IN THE APPROPRIATE BLOCKS 1, Did decedent make a transfer and: Yes No a, retain the use or Inoorne of the property transferred; """,,,,,.,.,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,""''''',,.,,,.,,''''',,. 0 00 b, retain the nghtto designate who shall use the property transferred or ns income; """""".""""""""",,""'" 0 00 c, retain a reversionary interest; or """"""""""""""""""""""""""""""""""",,.,,""""""""""""'" 0 00 d, receive the promise for loe of either payments, benefits or care? ."."."""""""""""""""""",,"""""""" 0 00 2, If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiYlng adequate consideration?",.,,,............................,,..................,,,,,.,..,,,,,,,,,,, "',""""""",' 0 00 3, Did decedent own an 'in t",slfo~ or payable upon death book account or security at his or her death? ..............." 0 00 4, Old decedent own an Indiyidual Retirement Aocount, annuity, or other non-probate property which contains a beneficiary deaignation? ...........""..', """""""""""""",..""..,.,.,..........................',.........."" 00 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Underpenaties of perjury, 1 declare ltIat I have examined this retum, includi~ acccMT'lP'fl)'ing schedules and s1aIements. andtl the bestofmy knowledge and belief, it is true, correcl and compIele. Declaration of preparer othef than the personal representative is based on all Information of which prepcrer has Cfly knowledge. DATE /d/,cP7-o,{}. , PA 17025.1822 DATE 12117/02 PA 17111-5212 'frTU~: D~:4(~:d::~::.IN;;2TURN ~RANDIROAD ~ ENOLA SIGNATURE OF PREPARER 0 ~ ADDRESS 8150 DERRY S HARRISBURG For dates of death on or after July 1, 1994 and before January 1,1995, the tax rate imposed on the net yalue of transfers to or for the use of the surviving spouse is 3% [72 P,S, ~116 (a) (1,1) (i)). For dates of death on or after January 1,1995, the tax rate Imposed on the net yalue of transfers to or for the use of the surviving spouse is 0% [72 P,S, ~9116 (a) (1.1) (Ii)), The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even 0 the surviving spouse is the only beneficiary, For dates of death on or after July 1, 2000: The tax rate imposed on the net yalue of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parerrt, an adoptive parent. or a stepparent of the child is 0% [72 P,S, ~9116(aX1,2)], The tax rate imposed on the net yalue of transfers to or for the use of the decedent's lineal beneficianes is 4,5%, except as noted in 72 P,S, ~9116(1,2) [72 P,S, ~9116(aX1)). The tax rate imposed on the net yalue of transfers to or for the use of the decedent's siblings is 12% [72 P,S, ~9116(a)(1.3)), A sibling is defined, under Section 9102, as an indiyidual who has at least one parent in common with the decedent, whether by blood or adoption, REV,...x'I"" . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER SHERK SANDRA J 21 02 0423 AI INI property owned 101ely or II I Isnlnt In common must be "POrted 1\ IIlr morUt VlIue. Fair lIIllI1<et value is defined as 1I1e price at which properly wookJ be exchangsd between a willing buyer and a Willing seller, neither being compelled to buy or sell, both having reasoneble knowledge of 1I1e relevant fads. Rul property which Is jolntly-owned wIlh right of IU",NolShl" must be disclosed on Schedule F. ITEM NUMBER 1. 2 3 4 5 DESCRIPTION VALUE AT DATE OF DEATH 89,900.00 ,U , t'RICF 60 OLIVER ROAD ENOLA, PA 17025-2124 SELLER ASSIST PER AGREEMENT OF SALE 60 OLIVER ROAD ENOLA, PA 17025-2124 COUNTY TAX ADJUSTMENT 60 OLIVER ROAD ENOLA, PA 17025-2124 SCHOOL TAX ADJUSTMENT 60 OLIVER ROAD ENOLA, PA 17025-2124 SEWERlTRASH ADJUSTMENT 60 OLIVER ROAD ENOLA, PA 17025-2124 -3,700.00 94.28 866.55 30.52 I TOTAL (Also enter 00 line 1, Recapttulation) $ (If more space is needed, insert additional sheets of the same size) 87.191.35 """",,"""". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN R I T ESTATE OF SHERK SANDRA J All property jolntly-owned with right of Iurvivorshlp mUlt bI dilclolld on Schldule F. SCHEDULE B STOCKS & BONDS FILE NUMBER 21 02 0423 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 0:00 ..."'...., TOTAL (Also enter on line 2. Recapitulation) $ (It more space;s needed, Insert additional sheets of the same size) 0.00 REV"''''''''.''. COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN R I T ESTATE OF SHERK SANDRA SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP J FILE NUMBER 21 02 0423 Schedukl C-1 or C-2 (Induding all suppol1ing informa1ion) must be attached for each cIose~-heId corporation/partnership interest of the decedent, oIt1er than a sole-proprie\orship. See inslnJcIions for the supporting information to be submitted for soIe-proplieforships. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 0.00 NON!: TOTAL (Also enter 00 line 3, Recapnulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REIf'l50TEX.(1.sT) *' SCHEDULE D MORTGAGES & NOTES RECEIVABLE COMMONWEALTH OF PENNSYLVANIA INHE~TANCE TAX RETU~ RESIDENT DECEDENT ESTATE OF SHERK SANDRA J FILE NUMBER 21 02 0423 AU property jolntly-o...ed with the right ohurvlvo"hlp must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 0.00 TOTAL (Also enteron line 4, Recapitulation) $ (If more space is needed, insert addnional sheets of the same size) 0.00 REV'''''''''''',* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF SHERK SANDRA J FILE NUMBER 21 02 0423 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 2 ERIE INSURANCE AUTO POLICY REFUND 103.00 TOTAL (Also enter on line 5, Recapitulation) $ (~more spaoe is needed, insert additional sheets of the same size) 6 003.00 REV"""EX'''''"* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF SHERK SANDRA J FILE NUMBER 21 02 0423 K an asset was made joint _in one year of the _.nrs dele of death, l must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME AODRESS RELATIONSHIP TO DECEDENT A. ENOLA, PA 17025-1822 B c JOINTLY-OWNEO PROPERTY: LETTER DATE OESCRPTION OF PROPERTY lIOF OATE OF DEATH ITEM FOR JOINT MADE Include name offinlllCiaI institution 8ld balk account number Of similar identifying nulTtler. Attach DATE OF DEATH DECClS VALUE OF NUMBER TENANT JOINT deed for joinUy-heId real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 10/16/01 PNC BANK, NA #5000821266 SAVINGS 15,976.80 50. 7,988.40 ENOLA, PA 2 A 10/16/01 PNC BANK, NA #5140057351 CHECKING 26,835.43 50. 13,417.72 ENOLA, PA TOTAL (Also enter on line 6, Recapfiulation) $ 21.406.12 (If more space is needed, insert additional sheets of the same size) , . REV","""""". COMMONWEALTH OF PENNSYLVANIA INHEroTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY ESTATE OF SHERK SANDRA J FILE NUMBER 21 02 0423 Th~sc!ledule must be completed and filed Wthe answer to any of questions 1 through 4 on the rev.... skHl of the REV-l500 COVER SHEET ~ yes. DESCRIPTION OF PROPERTY %OF ITEM INQ.Uoe THE NAME OF THE TRANSfEREE, THEIR R8.ATlONSHPTO cecer.ENT ~D THE DATE OF TRANSfER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH ACOPVOFTHE OEED FCfl REAL ESTJ\TE. VALUE OF ASSET INTEREST llFAPP..1CAR.E) 1. 0.00 TOTAL (Also enter on line 7, Recapitulation) S 0.00 (If more space is needed, insert additional sheets of the same size) REV.""".'''". COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF SHERK SANDRA J FILE NUMBER 21 02 0423 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUN~RAL EXPEN8E~ 1- PA THEM EFUNERALHOME 7,710.00 2 ROLLING GREEN MEMORIAL PARK 870.00 3 CUMBERLAND LAW JOURNAL 75.00 4 CARLISLE SENTINAL 90.59 8. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of PelSOnal Represenfative (s) Sodal Security Numbe~s) I EIN Number of PolSOnal Represenfative(s) Street Address City Sfate Zip Yea~s) Commission Paid: 2. AttomeyFees JASON M. WEINSTOCK, HARRISBURG, PA 4,830.00 3. Fami~ Exemption: (If deoedenfs address is not tl1e same as claimanfs, attach explanation) Claimant Street Address City Sfate Zip Relationship of Claimant to Decedent 4. ProbeteFees CUMBERLAND COUNTY REGISTER OF WILLS 238.00 CARLISLE, PA 17013 5. AccountantsFees WEGE ASSOCIATES 1,000.00 8150 DERRY ST., SUITE B, HARRISBURG, PA 6. Tax Retum Prepare!s Fees 7. REAL ESTATE SETTLEMENT SHEET COSTS 7,661.18 8 EXPENSE TO MAINTAIN HOME UNTIL SOLD ELECTRIC 40.02 WATER 31.42 SEWER 87.75 GAS 130.03 PHONE 29.41 CABLE 40.06 HOME INSURANCE (NET) 47.00 9 MEDICAU DR. CONROY 100.00 10 FAMILY SETTLEMENT FEE/REGISTER OF WILLS 17.00 TOTAL (Also enter on line 9, Recapitulation) $ 22997.46 (If more space is needed, insert additional sheets of tlle same size) ""."'''''.,,.''. COMMONwEALTH OF PENNSYlVAMA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SHERK SANDRA SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS J FILE NUMBER 21 02 0423 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. NONE 0.00 TOTAL (Also enter 00 line 10, Recapnulatioo) $ (~more space is needed, insert additional sheets of the same size) 0.00 REV.,5,3.X.'. COMMONWEAL Tli OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER I. SCHEDULE J BENEFICIARIES 'A .I 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions. and lransfers under Sec. 9116(0) (1.2)) JUDITH A WISMAN 11 RAND' ROAD ENOLA, PA 17025-1822 FILE NUMBER '1 n? RELATIONSHIP TO DECEDENT Do Not Ult Trustee(l) SISTER nA"" AMOUNT OR SHARE OF ESTATE 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-l500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-l500 COVER SHEET $ (If more space is needed, insert additional sheets of tlle same size) WHEREAS, on the 26th dated October 3rd 2001 was admitted to probate as the last will of SHERK SANDRA (LA,:)l/ .t'lK:::>'l, lVllULJL1::; Register of Wills of CUMBERLA.'JC Couety, ?ecmsyl vania Certificate of Grant of Le~~ers No. 2002-00423 PA No. 21-02-0423 ESTATE OF SHERK SANDRA (LAo'l, 1'1"01, YIllJlJLlo) Late of EAST PENNSBORO TOWNSHIP ~UM~~KLN~U LUUN~~1 Deceased Social day Security of April 2002 an instrument No. 204-28-2159 late of EAST PENNSBORO TOWNSHIP CUMBERLAND Coum:y, W!10 died on tr.e 15th day of April 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Will.s in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to WISMAN JUDITH A who has duly qualified as Executor (rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND CO'wqTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 26th day of April 2002. ~;r]J(/ Y (!:yti~/L'.~NU// !(.t-,ffiuA(./ y ~ eglSG r of II s / , **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) 21-02-423 LAST WILL AND TESTAMENT OF SANDRA SHERK I, Sandra Sherk of EnoIa, Cumberland County, Pennsylvania, being of sound and disposing mind, hereby make, publish and declare this [0 be my Last Will and Testament hereby revoking all former Wills and Codicils made by me. ITEM I: I direct that all my legal debts and funeral expenses shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I direct and bequeath all of my estate of every nature and wherever situate to my sister, Judith A. Wisman, providing she shall survive me by thirty days. ITEM III: In the event my sister predeceases me or dies on or before the thirtieth day following my death, I devise and bequeath all of my estate of every nature and wherever situate, in equal shares, to: Todd B. Wisman, Jeffrey M. Wisman, and Jamie L. Daugherty, who survive me. If any of the above do not survive me, I give his or her share to such person's issue, per stirpes, who survive me. ITEM IV: I direct that all taxes tha~ may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM V: I appoint my sister, Judith A. Wisman, Executrix of this my Last Will. Should she fail to survive me or is otherwise unwilling or unable to serve then I appoint Todd B. Wisman, Jeffrey M. Wisman and Jamie L. Da.JJgherty, as Co-Executors, of this my Last Will. ITEM VI: I direct that my Executrix or her successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction, and should, notwithstanding this direction, a bond be required, I direct that a surety bond not be required. IN WITNESS WHEREOF, I have hereunto sel my hand this 3. d day of Oc-tobe.r , 200 1. cJ~c:ru SANDRA SHERK - 2- The preceding instrument, consisting of this and two other typewritten pages identified by the signature of the Testatrix, SANDRA SHERK, was on the day and date thereof signed, published and declared by SANDRA SHERK, the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. /'~) J .-l ~1~ { c:;:fj'oULU...JL. .' /)- R.1- Name Q ~ '\ . . \\ 3D t. jiLcu,-- '.JL Address j / -, cNfJ UU I /)1 r;q 3 A t ^ finof" /3. tJc~i~ji Rn(J 111. :;~{fh(7( sf: Address Ij);"tl-p !J ~J Name !1c;yftfbWj.1ft /7/rJd. 1291 ahflthJPi)dn yY. Address Jltf:.f-rs I>tl"u fd /71/2' 9/3'1 . I r " COMMONWEALTH OF PENNSYLVANIA) ) ss: COUNTY OF ..:u a...u\Jh.';"{ \ ) ---- -.J Df? n We, J'f'j,.IJJD R...J7 0. [)(')()~~, /2; ~) J2~ii:' , --Ko6ere:/a and 'vi EN'i>'j j)i3:J il,,!! C /!!Dle'l , the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed this instrument as her Last Will and Testament and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, in that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and to the best of their knowledge, the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ()~ 1.~ ~ V . c... . !I C 0 iLL~"t.- 7) ff-t c r'J r cgd0 f3 A~~c;- t{ L"f"'j I( ;>J21?1 SWORN and Subscribed to and before me this 3r d day of _ Dc:..+Cbe r , 2001. J 2J:;.r.pc... (I\)~v Notary Public NOTARIAL SEAL liNDA WiTMER, Notary Public Harrisburg, Dauphin County PA My Commission Expires 03-20-2004 ./> . '. ~ I t"" '1;n~1-<Ctlt>1 1-< ~ t>1~ ~~Ctl t'1 (") ~ ~t;J ~ ,.., (") r ,., ,.., t,~ !:J !:1 ent>1 ~,.., '" l?~ K[51'1;O t'1 :;0 ~i .. en t"" t'1"l en <l~~ CtlO _*aT ~~ ~ H g; ~"l ,.., ~i3. -i '" >< en en '" '" ffiiri ~ H to ~ en Ii N ;l>no ,.., 0" !":l ..... ~ 0:;0 ~ ,,0. I :@O "" t"" 0 .. '" N ~H ~ H~ I 0 a;~ zr ~ ~ ~ ~ ~~ ",r N J Cj -'" W N en ~" 8'" .... a- 0:1 "'w c: 'Jl I H '" " N '1; -i 0 0 N L". " / ' ct't- INRE: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA. SANDRA SHERK, Deceased No. 21-020423 Date of Death: April 15, 2002 STATUS REPORT UNDER RULE 6.12 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? No B. The separate Orphans' Court No. (if any) for the personal representative's account is: 21-020423 C. Did the personal representative state an account informally to the parties in interest? Yes. See Family Settlement and Final Release attached hereto. D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' and may be attached to this report. Date: / /~t/03 , , , i /"") , _.~)l-'"l .~.~. - ;/ (01)7:;. 800 North Second Street Harrisburg, P A 17102 717-238-1657 Capacity: _ Personal Representative ~ Counsel for Personal Representative //}-60 -3 'v BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX FRED WEGE 8150 HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-17-2003 SHERK 04-15-2002 21 02-0423 CUMBERLAND 101 H WEGE JR ASSOCIATES DERRY ST STE B PA '* REV-1541 EX RFP 101-D31 SANDRA J Allount Rellitted 17111 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =iS4-j-i3f-AFP--loY:03Y-NOYici--OF-YNHiifiTANCE-YA'X-'A-pPRjrisiMENT~--AL1-owAircE-(fR------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHERK SANDRA J FILE NO. 21 02-0423 ACN 101 DATE 03-17-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 87.191.35 .00 .00 .00 6.003.00 21. 406.12 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 22,997.46 .00 NOTE: .00 X .00 X 91,603.01 X .00 X NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 114,600.47 (11) (12) (13) (14) 22.997 46 91,603.01 .00 91,603.01 00 = 045 = 12 = 15 = .00 .00 10,992.36 .00 10,992.36 (19)= ,,~v~.. . (+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 01-21-2003 CD002067 .00 10,992.36 BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-22-2003 TOTAL TAX CREDIT 10,992.36 BALANCE OF TAX DUE .00 INTEREST AND PEN. 9.04 TOTAL DUE 9.04 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF SANDRA SHERK KNOW ALL MEN BY THESE PRESENTS: WHEREAS, Sandra Sherk, late of East Pennsboro Township, Cumberland County, Pennsylvania died testate on April 15, 2002. WHEREAS, Judith A. Wisman applied for Letters Testamentary, and was granted the Letters on April 26, 2002; WHEREAS, Letters Testamentary, on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, to the said Executrix, hereinafter called Executrix; WHEREAS, the Executrix did advertise the grant of letters and obtained proofs of publication which are attached hereto as Exhibit "A"; WHEREAS, the said Executrix has gathered the assets of the estate of the said decedent and the assets consist of both real property and personal property, to a total value of $114,600.47; WHEREAS, the following debts, administrative costs, and deductions, including the payment of inheritance tax in the said estate, amount to $33,989.82: Parthemore Funeral Home $ 7,710.00 Rolling Green Memorial Park $ 870.00 Cumberland Law Journal $ 75.00 Carlisle Sentinel $ 90.59 Cumberland County Register of Wills $ 238.00 Real Estate Settlement Costs $ 7,661.18 Electric $ 40.02 Water $ 31.42 .. Sewer $ 87.75 Gas $ 130.03 Phone $ 29.41 Cable $ 40.06 Home Insurance $ 47.00 Dr. Conroy $ 100.00 Wege Associates (CPA) $ 1,000.00 Ira H. Weinstock, P.c. $ 4,830.00 Inheritance Tax $ 10,992.36 Register of Wills (Family Settlement) $ 17.00 Total $ 33,989.82 WHEREAS, the balance for distribution has been reduced to cash and has been distributed as herein indicated in accordance with the terms of this Family Settlement and Final Release. NOW, THEREFORE, KNOW YE, that I, Judith A. Wisman, being the heir of the said decedent, and being that person being entitled to inherent, do hereby, acknowledge that I have this day had and received from the aforesaid personal representative, full satisfaction and payment of all sums or sums of money, which amount I have received this day, and which amount is in the amount set opposite my respective names in the Table and Schedule of Distribution in said statement attached hereto and marked Exhibit "B"; AND, I do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby agree that I do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if it had been filed and confirmed by the Register of Wills, Cumberland County. THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said Executrix, Judith A. Wisman, heirs, executors, and administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever touching upon the estate of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, I do hereby covenant and agree that I will contribute my share of the estate after the signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date set forth below. WITNESSES: ~ In. C~ /~~/;J ~ Judith A. Wisman STATE OF PENNSYLVANIA COUNTY OF Cu. M be..r L f\ N &. ) ) ss: ) On this, the ~day of TI\Nu..~ ri ,2003, before me, a Notary Public, the undersigned officer, personally appeared Judith A. Wisman, to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. --1kL 1Il. C~ Notary Public I~l ()3 I NOTARIAL SEAL HELEN M. GRIFFITH, Nntary Public I East Pennsbofo Twp. Cumberland Co. J. MyCommlssiOfl~[es ~!~_~ PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland. Lori Saylor, Classified Advertising Manager of THE SENTINEL, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following dates, viz Copy of Notice of Publication " NO'ttce LETTERS T AMENTA- RVlITth6 SANDRA !;!ite , of East Pennsboro Township, C Cumberland s- nia, deCe , avi!1g been ranted to Jlfdlth A. I persons i el!,la~ are make imm ;mil th or deman t the same without d.y to: May 16, 23 & 30, 2002 Affiant further deposes that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. Judith A. Wisman, Executrix 11 ~ndL69ad tnolll,PA 1 'f0J?5 I :or to: , Jason M. Wein$tO~k, EsqUire , 800 North Second Street I Hafrisbiltg, PA 171 O? ~ ~t>L May 31,2002 Sworn to and subscribed before me this 31 st day of May , 2002. 0!u.clLv/ O. ~/tUVJ Notary Public My commission expires: NOT ARIAL SEAL SHIRLEY O. DURNIN, Notary Public Carlisle Bora., Cumberland County Commission Ex 'res Au . 9, 2003 EXHIBIT "An PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA: ss. COUNTY OF CUMBERLAND : Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues ofthe said Cumberland Law Journal on the following dates, VIZ: MAY 24, 31, JUNE 7, 2002 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. ~ R ger M. Morgenthal, EdItor ---. Sherk, Sandra. dec'd. Late of East Pennsboro Town- ship. Executrix: Judith A. Wisman. 11 Randi Road, Enola, PA 17025. Attorney: Jason M. Weinstock, Esquire. 800 North Second Street. Harrisburg, PA 17102. SWORN TO AND SUBSCRIBED before me this 7 day of JUNE. 2002 NOTARIAL SEAl LOIS E. SNYDER, ~ PublIc CarflsIe Bora. Cumberiand County My Commissbl ExpiI1I Man:h 5, 2005 Name of Relative 1. Judith A. Wisman SCHEDULE OF DISTRIBUTION Share of Estate 100% EXHIBIT "B" I~~-'---"-"'-'----'-""-' --_.._-~----- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WEINSTOCK JASON M ESQUIRE 800 NORTH SECOND STREET HARRISBURG, PA 17102 nnnn fold ESTATE INFORMATION: SSN: 204-28-2159 FILE NUMBER: 2102-0423 DECEDENT NAME: SHERK SANDRA DA TE OF PAYMENT: 01/05/2006 POSTMARK DATE: 01/05/2006 COUNTY: CUMBERLAND DATE OF DEATH: 04/15/2002 NO. CD 006178 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9.04 I I I I I I I I TOTAL AMOUNT PAID: $9.04 REMARKS: MIDSTATE ABSTRACT CHECK# 116553 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS .,,~L./......:J ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION OEPT. 2:8'0601 HARRISBURG, PA 1712:8-0601 FRED H WEGE JR WEGE ASSOCIATES 8150 DERRY ST STE B HBG PA CUT ALONG THIS LINE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE " NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX IEY-1547 EX AFP lDl-151 :: . '-(... DATE ESTATE OF DATE OF DEATH FILE NUMBER " ,') :>:' L,COUNTY ACN 03-17-2003 SHERK 04-15-2002 21 02-0423 CUMBERLAND 101 J SANDRA .!.at) Amount Remitted .1 Inn ~,~'-\ ------------------------------------------------------------------------------------------------------------ ~ MAKE CHECK PAYAB~E AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAIN LOWER PORTION FOR YOUR RECORDS ~' BUREAU OF INDIVIDUAL TAXES, INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17126-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) FRED WEGE 8150 HBG H WEGE JR ASSOCIATES DERRY ST STE B PA DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-17-2006 SHERK 04-15-2002 21 02-0423 CUMBERLAND 101 SANDRA J Amount Rellitted 17111 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS 4- REV-1607 EX AFP (03-05) :IBBE INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF SHERK SANDRA J FILE NO.21 02-0423 ACN 101 DATE 01-17-2006 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-17-2003 PRINCIPAL TAX DUE: 10,992.36 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-21-2003 CD002067 .00 10,992.36 01-05-2006 CD006178 9.04- 9.04 TOTAL TAX CREDIT 10,992.36 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 If SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) I<A